المنتدى العالمي المعني بالأمن الغذائي والتغذية

Much of the Work Programme is common with the Global Panel’s on-going work. Specific comments, as well as areas where the Global Panel can provide knowledge and evidence to help deliver this Work Programme, are presented below. It is hoped these comments prove helpful and should not detract from what is a well-considered and constructive document.

The Global Panel Secretariat stand ready to work with partners across the food system to deliver this timely and important initiative.

General comments

The Panel strongly endorses the need to promote coherence of national, regional and international policies across multiple sectors, including through improved monitoring and reporting of relevant policy impact at national, regional and global levels. This has been highlighted in the Panel’s policy and technical briefs, as well as the Foresight Report Food systems and diets: Facing the challenges of the 21st century. These documents, as well as other forthcoming evidence-based briefs will help support many of the proposed action networks (Table 1 of the Work Programme). The Panel will also continue to engage influential policy makers in low and middle-income countries, through high-level round table meetings, advocacy, and tools to help decision makers implement the policy changes required to make this Decade of Action a success.

It is largely accepted that the world faces a triple burden of underweight, overweight and micronutrient deficiencies. This is particularly important in low and middle-income countries where issues of obesity and the associated non-communicable disease are becoming increasingly problematic. As the Panel’s Foresight report shows, by 2030 Sub Saharan Africa’s obesity rate is expected to reach 17.5%, which is double that of 2005. In Ethiopia, the number of adults with diabetes could double by 2030 from 1.4 million to 2.7 million. The current Work Programme gives little reference to overweight and obesity. For example, the word “obesity’ only occurs three times and in section 9 (Aims and Added Value) it only occurs in a footnote. Likewise, there is little mention of childhood obesity. It is felt that actions to prevent the rising tide of overweight and obese adults and children, through low quality diets, particularly in low and middle-income countries, should be more apparent in the Work Programme.

Whilst the concept of food systems is refereed to in Action area 1, the concept of the food system, in bringing together food, agriculture, nutrition and health with other areas of policy, for example infrastructure, trade, social development and welfare could be better emphasised and defined. The food system is an overarching framework through which higher quality diets will be achieved.

Action area 1: Sustainable, resilient food systems for healthy diets:

This section appears to focus on agriculture and food safety, with not enough emphasis on the food system as a whole. Perhaps this section could be structured to set out the various parts of the food system that need to be considered, highlighting the need for integrated approaches which work throughout food systems.

Para 19: It may help to define the terms “social, economic and environmental sustainability”. For example, does environmental sustainability include water, carbon, soil health, or biodiversity?

Action area 2: Health systems:

This section, although very important, is quite general. Is it possible to provide specific priorities relating to malnutrition in all its forms?

Action area 3: Social protection and nutrition education:

It may be advantageous to highlight the need for all countries to develop better food-based dietary guidelines (para 32) and, more specifically, how these should be used to inform policy.

Action area 4: Trade and investment:

It may be worth adding that food production is also used for important non-food purposes, for example generating exports and overseas currency, biofuels, packaging materials, and alcohol.

Action area 5: Safe and supportive environments for nutrition at all ages:

With urbanisation mentioned as a proposed action network (Table 1 of the Work Programme), it may be worth highlighting the specific nutrition challenges of urban environments in this section.

Likewise, it may be worth giving reference to the concept of a ‘food environment’ in this section (following the work of Herforth, Ahmed, Swinburn, Hawkes, et al.)

Action area 6: Governance and accountability

Giving priority to collecting better data on what people are actually eating would strengthen this section. The lack of good data is currently a serious limitation for effective evidence-based policymaking.

With reference to King Letsie III of Lesotho and other high profile advocates, for example the African Leaders for Nutrition initiative, highlighting the need for real high-level global leadership and commitment may be worth mentioning in this section.

The section on “Accountability and Shared Learning” could emphasise the need to analyse why specific actions work well or less well in specific circumstances, and to share those lessons with a view to modifying priorities and actions. 

Prof Sandy Thomas

Director, Global Panel on Agriculture and Food Systems for Nutrition

WaterAid response to consultation on the draft work programme of the UN Decade of Action on Nutrition 2016-2025

WaterAid welcomes the transparency of the planning of the UN Decade of Action on Nutrition 2016-2025 (hereafter the Nutrition Decade) and the opportunity to comment on the draft work programme.

We warmly welcome the draft work programme’s emphasis on the need to convene, coordinate, enhance cooperation and drive action across multiple sectors and actors. This will be critical to accelerating progress towards the goal of ending malnutrition by 2030. We particularly support and welcome the emphasis within Action area 5 (‘safe and supportive environments for nutrition') on integrating the recommendations of the ICN2 Framework for Action on water, sanitation and hygiene.

Water, sanitation and hygiene (WASH) are fundamental to ending undernutrition. The WHO estimates that 50% of undernutrition is associated with repeated diarrhoea, intestinal worm and other infections (environmental enteric dysfunction) directly resulting from inadequate WASH.[1] WASH therefore needs to be integrated into national nutrition policies, strategies and plans, with joint multi-sector action, and increased domestic and international funding for WASH as a key ‘nutrition-sensitive’ intervention. WaterAid calls for the Nutrition Decade to provide strong leadership in urging Governments to achieve much more effective integrated action on Nutrition and WASH.

1. Does the work programme present a compelling vision for enabling strategic interaction and mutual support across existing initiatives, platforms, forums and programmes, given the stipulation of Res 70/259 that the Decade should be organized with existing institutions and available resources?

We welcome the emphasis in the workplan on coordinating with and building upon existing institutions and initiatives, rather than further fragmenting global governance and accountability mechanisms. The emphasis is rightly on supporting the development and implementation of ambitious national nutrition action plans – reiterating the need for country ownership that is fundamental to the work of the Scaling Up Nutrition (SUN) Movement.

While the work programme stresses the need for action by “multiple actors from all sectors”, and specifically references Every Woman, Every Child (EWEC) as one important existing initiative, it should make clearer links to existing initiatives and platforms in other nutrition-relevant sectors. For instance, the work programme could highlight the need to build upon the early efforts to coordinate between SUN, the Sanitation and Water for All partnership (SWA) and the Global Partnership for Education (GPE). The Nutrition Decade should provide additional impetus and convening opportunities to significantly shift global governance in this more coordinated, more harmonised direction which will be fundamental to driving ‘nutrition sensitive’ investment and action.

2. What are your general comments to help strengthen the presented elements of the first draft work programme of the UN Decade of Action on Nutrition?

‘Aims and Added Value’

(para 9) The stated aims should be strengthened by a greater emphasis on not just “addressing” malnutrition (implying a focus on treatment) but preventing it. We propose an additional clear aim to “Support all countries’ efforts to prevent malnutrition through effective multi-sectoral action to address the underlying determinants”.

Action areas

(para 18) The reference to conducting “a full and thorough mapping” of existing initiatives and movements is welcome. We propose that this should explicitly include initiatives between nutrition-relevant sectors. For instance, SUN and the SWA have recently agreed a joint work plan for action on WASH-Nutrition integration – this may provide a useful model and example of cross-sectoral action at the global governance level.

Action area 1

(para 21) Water availability and water resource management are critical aspects of sustainable food systems (e.g. for adequate and consistent supplies to crops and livestock as well as people) and should be referenced.

(para 23) Improving access to WASH is fundamental to preventing Anti-Microbial Resistance (AMR).

Action area 2

(para 25) Achieving UHC requires that the fundamentals of good quality healthcare are in place. Yet the WHO estimate that 38% of healthcare facilities in low- and middle-income countries lack access to water[2]. 19% do not have adequate sanitation and 35% do not have soap for handwashing. In Sub-Saharan Africa, 42% of healthcare facilities do not have access to water. Ensuring adequate WASH in healthcare is critical to delivering quality health care, including the treatment of malnutrition. The Global Action Plan on WASH in Healthcare Facilities co-led by WHO and UNICEF is therefore a key initiative to highlight and coordinate with that will be fundamental to improving nutrition.

Action area 5

(para 37) We strongly welcome the inclusion of an area on water, sanitation and hygiene. Poor WASH is linked to nutrition in multiple ways, beyond diarrhoeal disease. The direct biological pathways through which poor WASH is linked to undernutrition includes diarrhoeal diseases, intestinal worms, and environmental enteric dysfunction, a sub-clinical condition which affects the structure and function of the small intestine, resulting in the poor absorption of nutrients. The paragraph would be strengthened by including a more thorough overview of the key links between WASH and nutrition, and a greater emphasis on the role of hygiene behaviour change as a critical intervention to break the common routes of faecal-oral transmission.

Means of Implementation

(para 45) We strongly support the proposal for “a publicly-accessible repository” of commitments made by Member States in support of the Nutrition Decade, which will help to drive transparency and accountability. This is particularly crucial for commitments to ‘nutrition sensitive’ action, which are often less easy to track and carry greater risk of ‘double-counting’ of existing commitments in other sectors without sufficient thought and effort to enhance nutrition-sensitivity.

3. Do you feel you can contribute to the success of the Nutrition Decade or align yourself with the proposed range of action areas?

Yes, WaterAid stands ready to contribute towards the success of the Nutrition Decade. Our advocacy on the need for integration of WASH and Nutrition in policies and practice will be key. We have already established relationships and initiatives with the aim of enhancing coordination and integration, working closely with SUN, SWA, the Global Nutrition Report team, EWEC and WHO, among others.

We propose that WASH-Nutrition integration could be a specific topic for the development of commitments and the establishment of action networks, adding to those suggested in Table 1. We would argue that to have one topic on “Nutrition sensitive investments” as currently listed may be too broad a topic to allow the in-depth sharing of experience and knowledge necessary to enhance effective multi-sectoral action.

4. How could this draft work programme be improved to promote collective action to achieve the transformational change called for by the 2030 Agenda for Sustainable Development and the ICN2 outcomes? What is missing?

The work programme must drive a step-change in multi-sectoral coordination for effective Nutrition-sensitive investments and actions. The Global Nutrition Report in 2016 highlighted that scaling up nutrition-specific interventions to 90% coverage in 34 of the countries with the highest burden of child undernutrition, will only reduce stunting by 20%.[3] Therefore effective nutrition-sensitive action will be absolutely vital to meeting the goals of the Nutrition Decade and SDG 2. This should be reflected in the work programme by:

• (para 13) Making explicit within the ‘guiding principles’ the need to ensure ambitious funding for ‘nutrition-sensitive’ as well as ‘nutrition-specific’ action, and the role of the Nutrition Decade in convening high level stakeholders across nutrition-relevant sectors.
• (para 49) Ensuring that ‘Action Networks’ have the active participation of government representatives from across nutrition-relevant ministries such as Ministers or senior officials for WASH, Education, Agriculture, Health, Planning and Infrastructure.
• (paras 55, 56) Emphasising that funding modalities and the mobilisation of new financial resources must include ambitious commitments to nutrition-sensitive investments. While the World Bank / R4D estimates of the cost of achieving global nutrition targets is an important benchmark, it should not be treated as definitive. Their conclusion that an annual additional $2.2 billion of financing is required to deliver a ‘priority package’ of interventions clearly states that this estimate is predicated on the assumption of “ambitious commitments in water and sanitation”[4], among other nutrition-relevant sectors. Further urgent work is needed to improve the costing and tracking of nutrition-sensitive investments by governments and donors, including improving resource tracking of ODA via OECD DAC measurement.

5. Do you have specific comments on the section on accountability and learning?

We welcome the proposals for transparency and accountability. A focus on shared learning is particularly critical for integration and effective nutrition-sensitive action, where the evidence and cost-effectiveness of interventions is still being researched. It is vital that governments and donors do not only invest in and report on the more limited set of nutrition-specific interventions – since this will not result in meeting the goal to end malnutrition by 2030. Rather, the Nutrition Decade must act to galvanise rapid experimentation, evaluation and learning to strengthen the global nutrition community’s understanding of what works in effective multi-sectoral action.

Spanish version below

1. Does the program of work contain a compelling approach allowing for strategic interaction and mutual support among existing initiatives, platforms, forums and programs, taking into account the provisions of Resolution 70/259, under which the Decade should Organize with existing institutions and available resources?

From the structure of the draft document of the decade's work program, I can observe and highlight the following strengths: it includes normative aspects and previous commitments, defines objectives and added value, has defined principles that guide actions, clearly defines areas of action, contemplates Means for its implementation. Likewise, malnutrition and its associated problems stand out, which constitute challenges for the countries.

Similarly, the launching of these consultations, as an inclusive strategy, with open-ended participatory spaces that contribute from different perspectives to improve the horizon for global nutrition in the next decade.

Regarding strategic interaction and mutual support, while there are important advances in countries, defining mechanisms to monitor and verify progress periodically, in addition to accountability, there must be information systems and strategies that make it possible to give visibility to Achievements, guidelines should be given to strengthen or define operational mechanisms within countries to meet the goals and objectives of the decade at the regional and local levels.

2. What are your general comments to help improve the elements of the first draft of the program of work of the United Nations Decade of Action on Nutrition?

As expressed in the answer to the previous question, I consider that the draft document highlights essential elements that justify the formulation of actions that will allow in a decade to observe a change in the panorama of global malnutrition; I recommend including food culture as an element to be taken into account in the definition of national, regional and local strategies, since in countries like Colombia, strategies and mechanisms of implementation may vary from one region to another, our country as many Others are multicultural, have diversity of climates, ethnic diversity and variety of food.

Likewise, I think it is urgent to transcend food and nutritional security discussions from expert groups gathered at food summits, to the vision of food-nutritional security from the ecosystem view as an interdependent set of complex systems that They enter into the biological and social networks of life[1]. That is to say, other perspectives must be generated in which the thoughts and knowledge that arise from the same contexts as the sovereignty and the food wisdom, the well-being of the alimentary-nutritional life plots, should be generated.

Food and nutritional security with a systemic approach should be visible from other perspectives in which the thoughts and knowledge that arise from the same contexts as the sovereignty and the food wisdom be the well-being of the food-nutritional life plots[2].

3. Do you think you can contribute to the success of the Nutrition Decade or align with the various areas of action proposed?

Yes, of course. The objectives of the Nutrition Decade should be welcomed by all stakeholders in all areas of action, in the case of Colombia as regards the National, Regional, Departmental, Municipal and local levels.

Personally from my training and area of ​​professional performance; I am a Nutritionist-dietitian and I work as a researcher at the Metropolitan University of Barranquilla, where we train health science professionals and among them nutritionists who are very interested in being active participants in solving the nutritional problems of the population of the Colombian Caribbean.

Nutrition content and sensitivity to nutritional problems should be included in the curricula of students from primary to undergraduate and postgraduate.

The academy can contribute from the training of professionals, contributing to the understanding and understanding of the nutritional and nutritional problems and developing capacity to sensitize themselves to the problems of the context and determined to put at their service the knowledge to propose and to develop sustainable solutions.

Research to propose innovative solutions at the service of communities is another of the strategies that should be made visible in this document.

Each of us professionals related to the problems of malnutrition and its causes and consequences can contribute from the environment where it lives and works to meet the challenges of the nutrition decade.

5. Do you have specific comments on the section on accountability and sharing?

Accountability reports within countries should be conducted in less than two-year terms and may be semi-annual and annual.

Generate spaces for dialogue and discussion within countries at national, regional, departmental and local levels that contribute to build on the needs of the population and be inclusive.

Identify and plan the monitoring and evaluation of achievements.

Define responsibilities in the countries.

Have qualified human resources.

Generate knowledge management strategies, in which the education sector and the academy play an important role from their role in training and research.

Strengthen observatories as information and knowledge management strategies.

Encourage the generation of knowledge networks.

Mylene Rodríguez Leyton

Teaching researcher

Metropolitan University

Barranquilla City

[1] Rodríguez, Mylene. Construcción de una episteme desde la perspectiva ambiental compleja para la gestión en seguridad alimentaria y nutricional. Tesis para optar el título de Magister en administración énfasis investigativo, Universidad Nacional de Colombia Sede Manizales. Manizales, Colombia. año 2010

[2] Ibid

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1. ¿Presenta el programa de trabajo un enfoque convincente que permite la interacción estratégica y el apoyo mutuo entre las iniciativas, plataformas, foros y programas existentes, teniendo en cuenta lo dispuesto en la Resolución 70/259 en virtud de la cual el Decenio debería organizarse con las instituciones existentes y los recursos disponibles?

Desde la estructura del documento borrador del programa de trabajo del decenio puedo observar y destacar las siguientes fortalezas: incluye los aspectos normativos y compromisos previos, define objetivos y valor agregado, cuenta con principios definidos que guían las acciones, define claramente áreas de acción, contempla medios para su implementación. Así mismo destaca la malnutrición y sus problemáticas asociadas las cuales se constituyen en retos para los países.

De igual manera exalto la puesta en marcha de estas consultas, como una estrategia incluyente, con espacios participativos de opinión abierta que contribuyan desde diversas perspectivas a mejorar el horizonte para nutrición mundial en el próximo decenio.

Respecto a la interacción estratégica y el apoyo mutuo si bien es cierto existen en los países avances importantes, definir mecanismos para realizar monitoreo y verificar los avances periódicamente, además de las rendición de cuentas, deben existir sistemas de información y estrategias que permitan dar visibilidad a los logros, se deben dar pautas para que al interior de los países se fortalezcan o definan mecanismos operativos para dar cumplimiento a las metas y objetivos del decenio en los ámbitos regionales y locales.

1. ¿Cuáles son sus comentarios generales para ayudar a mejorar los elementos presentados del primer borrador del programa de trabajo del Decenio de las Naciones Unidas de Acción sobre la Nutrición?

Como lo expreso en la pregunta anterior considero que el documento borrador  destaca elementos esenciales que justifican la formulación de acciones que permitan en una década observar un cambio en el panorama de la malnutrición mundial; recomiendo incluir la cultura alimentaria como un elemento a ser tenido en cuenta en la definición de estrategias nacionales, regionales y locales puesto que en países diversos como Colombia, las estrategias y los mecanismos de implementación pueden variar de una región a otra, nuestro país como muchos otros es multicultural, tiene diversidad de climas, diversidad étnica y variedad de alimentos.

De igual manera, pienso que es urgente trascender las discusiones de la seguridad alimentaria y nutricional de Grupos de expertos reunidos en las cumbres de alimentación, a la visión de la seguridad alimentaria-nutricional desde la mirada ecosistémica como un conjunto interdependiente de sistemas complejos que se entraman en las redes biológicas y sociales de la vida[1]. Es decir se deben generar  otras perspectivas en las cuales se privilegien los pensamientos y conocimientos que surjan de los mismos contextos como la soberanía y la sabiduría alimentaria el estar-bien de las tramas de vida alimentaria-nutricional.

La Seguridad alimentaria y nutricional con enfoque sistémico debe ser visible a partir de otras perspectivas en las cuales se privilegien los pensamientos y conocimientos que surjan de los mismos contextos como la soberanía y la sabiduría alimentaria el estar-bien de las tramas de vida alimentaria-nutricional[2].

1. ¿Cree usted que puede contribuir al éxito del Decenio de la Nutrición o alinearse con los diversos ámbitos de actuación propuestos?

Si. por su puesto los Objetivos del Decenio de la Nutrición deben ser acogidos por todas las partes interesadas en todos los ámbitos de acción, para el caso de Colombia en lo que concierne al ámbito Nacional, Regional, Departamental, Municipal y local.

Personalmente desde mi formación y área de desempeño profesional; soy Nutricionista- dietista y trabajo como docente investigador en la Universidad Metropolitana de Barranquilla, donde formamos profesionales de ciencias de la salud y dentro de ellos nutricionistas que están muy interesados en ser partícipes activos en la solución de los problemas nutricionales de la población del Caribe Colombiano.

Los contenidos de nutrición y la sensibilidad a las problemáticas nutricionales deben ser incluidos en los planes de estudio de los estudiantes desde la educación primaria hasta el pregrado y el postgrado.

La academia puede aportar desde la formación de profesionales, contribuyendo a la comprensión y entendimiento de los problemas alimentarios y nutricionales y desarrollando capacidad de sensibilizarse a los problemas del contexto y decididos a poner a su servicio los conocimientos para proponer y desarrollar soluciones sostenibles.

La investigación para proponer soluciones innovadoras al servicio de las comunidades es otras de las estrategias que debe hacerse visible en este documento.

Cada uno de nosotros los profesionales relacionados con las problemáticas de malnutrición y sus causas y consecuencias puede contribuir desde el entorno donde vive y trabaja a alcanzar los retos de la década de la nutrición.

1. ¿Cómo se podría mejorar este borrador de programa de trabajo para promover acciones conjuntas que logren el cambio transformador solicitado por la Agenda 2030 para el Desarrollo Sostenible y los resultados de la CIN2? ¿Qué echa en falta?

Incluir estrategias y mecanismos para hacer efectivo el trabajo en red desde las diversas partes interesadas en los distintos ámbitos de los países: nacional, regional, departamental, municipal y local.

Definir mecanismos lograr una gestión efectiva, por ejemplo generar espacios de discusión, construcción, planeación, ejecución, seguimiento y evaluación entre las distintas partes interesadas.

Para el seguimiento y evaluación definir indicadores que permitan medir los logros y establecer acciones correctivas en caso de ser necesario.

Exaltar el papel de la educación y los educadores en la contribución a la solución de las problemáticas alimentarias y nutricionales para lo cual deben incluirse en las disciplinas que sean pertinentes contenidos relacionados.

Ampliar el enfoque sistémico, además de los sistemas alimentarios sostenibles que son un elemento fundamental, podría proponerse un enfoque ecosistémico que implica su comprensión como procesos inherentes a la vida, estableciendo relaciones de interdependencia con todos  los sistemas vivos y sistemas sociales. donde los pueblos y las comunidades expresan sus necesidades alimentarias y nutricionales y buscan maneras solidarias de solución.

Dar pautas para identificar los puntos de encuentro de las interrelaciones entre los sistemas que las integran, las cuales se dan en sentidos diversos e integran, apropian y articulan saberes desde una mirada transdisciplinaria[3], esto permitirá identificar en los planes de acción responsabilidades compartidas, dar claridad a los roles y contribuciones de cada uno.

1. ¿Tiene comentarios específicos sobre la sección dedicada a la rendición de cuentas y el aprendizaje compartido?

Los informes de rendición de cuentas al interior de los países deben realizarse en plazos inferiores a dos años pueden ser semestrales y anuales.

Generar espacios de diálogo y discusión al interior de los países en los ámbitos nacionales, regionales, departamentales y locales que contribuyan a construir sobre la base de las necesidades sentidas de la población y sea incluyente.

Identificar y planear el seguimiento y la evaluación de los logros.

Definir responsabilidades en los países.

Contar con recurso humano calificado.

Generar estrategias de gestión del conocimiento, en las cuales el sector educativo y la academia jueguen un rol importante desde su rol en la formación y en la investigación.

Fortalecer los observatorios como estrategias de gestión de información y conocimiento.

Fomentar la generación de redes de conocimiento.

Dear Partners,

The document was well articulated and it contains the opinion of the masses.

My contributions are on how we can implement it to the later, Mobilization of stakeholders and inclusive participation will be the key to success.

As a farmer Organization, Implementation of this document will be beneficial to us especially in the production and utilization of our quality farm produce to produce Complementary feeding locally.

We the farmers association should be recognized and supported to produce home grown foods and fortification for our nursing mothers and under five year old born..

By so doing, we will grow our economy and enrich the health of our babies and citizenry.   

Beginning with “How could this draft work programme be improved to promote collective action to achieve the transformational change called for by the 2030 Agenda for Sustainable Development and the ICN2 outcomes?” and taking up the question, “What is missing?”, the draft seems to lack logical cohesions one would like in the sequence; what are our aims, and then how do we propose to achieve them. There is a mixing of these two, i.e., ends and means that might lead to confusion and inefficiency.

When I refer to organisations, I only mean the people who man them, and not in the sense of ‘legal entities’.

I shall quote from the First Draft to build a frame of reference that embodies the logical hierarchy of sequential actions that must be undertaken with sufficient skill to achieve at least some of the objectives the document describes. My point of departure is the super-ordinate goal of the ‘Decade’, viz., “to end all forms of malnutrition and leaving no one behind.” Envisioning “a world where all people at all times and at all stages of life have access to affordable, diversified, safe and healthy diets.”

I think we all agree that the above objective subsumes malnutrition in all its manifestations, including the excessive intake of some nutrients leading to obesity and the associated diseases caused by non-infectious agents. At this point, it would be wise for us to leave the medical aspects of malnutrition to health professionals, and concentrate more on how we may initiate and execute a coordinated joint action with them against ill-effects of malnutrition.

Of course, our super-ordinate aim subsumes a variety of goals   which the First Draft describes in terms of percentage reductions. These specific instances and some others would have been better placed at the top as the general nutritional objective, followed by its more specific manifestations. I shall not labour this point, and will proceed to the next stage.

Obviously, we are here concerned with how may we best achieve our objective. Once we have clearly identified the goals our overall objective would justifiably subsume, we can move onto deciding the best available means of achieving them and their areas of impact. I think it is at this point the current draft displays its weakness, because it does not distinguish clearly between ends to be gained, and then go onto determine how and where to act.

This is tricky indeed. Personally, I think it would be wise to outline where to act first, because the authority needed and the type and extent of competence required to carry out a given action varies with how a goal instantiates itself at different socio-political levels. However, we can resolve this difficulty by displaying how each level of authority or interest grouping may contribute to achieving our objectives as follows:

Top level- global authorities:

Eg. Un, FAO, WTO, etc.

Here may one list how these institutions may contribute in diverse ways within their range of action. For instance, WTO could refrain from imposing trade regulations that require countries to permit import, manufacture and sale of unhealthy food and beverages while promoting that of their opposite.

International interest groups:

Some Ngo’s.

Multinational food companies.

There is an inherent conflict of interests between these two groups. The dilemma is that compromises between them could only slow down the current increase in both forms of malnutrition, but not their long-term resolution. One may be averse to look the stark reality in face, but, it does not change the big picture.

For the sake of completeness, it must be noted that NGO’s may not agree on either the kinds of goals or on the order of their importance with respect to what we are trying to achieve here. In short, what we most require at this level is a general agreement on the goal to be pursued, and then a set of policies in the relevant areas  like agriculture, employment, trade, education, health, etc., which are in harmony with respect to our goal.

The regional level:

EU, etc.

Action it is appropriate for the regional authorities to undertake will have a greater specificity with reference to our objectives, and will take into account the region-specific considerations. Obviously, the relevant regional policies should be harmonious with respect to the regional variation of our overall goal.

Reconciling the conflicting aims of NGO’s and trade interests at regional level is not categorically different from those mentioned above.

National level:

Depending on the degree of political devolution, national, regional and local government authorities will be able to make contributions of increasing specificity with reference to the local food culture.

Provided that the NGO’s or any other volunteer groups agree on goals and their priorities, they could make a very significant contribution here.

Once again, when we deal with commercial interests, we encounter the same difficulties at a more specific level. For instance, it may involve attempts to replace/deprecate the local food culture by ‘high powered’ promotion of food and drink of questionable nutritional value.

Next, we have the specific public institutions like the ministries, educational institutions, the relevant research units, agricultural extension services, etc., whose contribution depends on skilful implementation of sound policies in harmony with what we intend to achieve.

Now we come to the final and the crucial target groups, viz., actual producers of food, independent retailers, small catering establishments (cafes and restaurants) and most of all, the people who are the end-users, i.e., all of us.

The draft ought to make this gradation among who should undertake  the actions necessary to achieve our objective, for generally speaking, a farmer may not be the best person to formulate national agricultural policy, nor yet a minister of agriculture  competent to cultivate that farmer’s fields. So, we need to assign each required action to those most competent to carry them out. It will be seen they follow the rule, higher the authority greater the generality of action which requires having a sound overall view of the problem, while at the operational terminus, one needs greater /agricultural technical competence.

The draft describes some of the ‘how’s’, but not very clear about to whom they are assigned. Obviously, it would be helpful if it lists the ‘how’s’ assigned to the international, regional and national (local) institutions respectively.

What I have in mind is something like the suggestion below:

International (global):

FAO/International organisations shall …

 “Support all countries’ efforts to address all forms and causes of malnutrition;”

“Stimulate the effective translation of the ICN2 commitments and the 2030 Agenda for SDG-2into concrete, nationally-determined policies and programmes;”

“Promote harmony within and among the relevant policies at international, regional and national levels to combat all forms of malnutrition, including through improved monitoring and reporting of relevant policy impact at global, regional and national levels;” (I have re-ordered the logical priorities, and believe this ‘how’ on policy should lead the list)

I should add to this list---

To promote fair trade in victuals at international, regional and national levels;

To ensure highest priority given to the availability of financial and other appropriate resources required for food production;

I think it will be agreed that the above non-exhaustive list   describes the assignment of ‘how’’s at the highest level of authority at the three levels we have discussed. Before proceeding to how our objective may be attained at national level, it is necessary to consider the question of partnerships, which let me repeat is one of the ‘how’s’. We may use to achieve our aim.

Leaving out its link to our goal:

“…. through Catalysing and facilitating alignment of on-going efforts of multiple actors from all sectors, including new and emerging actors, to foster a global movement to achieve the above objective.”

First, we run into the problem of sovereignty and constitutional restraints. Other things being equal, international, regional and national policies are to be laid down by the ‘elected’ representatives of the people.  Even if their disinterestedness could be guaranteed, to what extent non-governmental bodies may be allowed to influence this policy-making process is subject to legal and constitutional restraints.

Secondly, one has to determine at what level such partnerships could make a worthwhile contribution. Subject to the provisions outlined below, some partnerships may help us at intermediate level of operations and down. This corresponds to what happens after the general strategies have been carried out to implement the required policies. I have expanded on this point here: http://www.fao.org/fsnforum/cfs-hlpe/node/1272

Question: What are your general comments to help strengthen the presented elements of the first draft work programme of the UN Decade of Action on Nutrition?

As I have outlined above, the draft will benefit from describing a categorical hierarchy of goals, i.e. main aim followed by its increasingly specific manifestations.

Then, it ought to consider who should do what to achieve our aim. This ‘who’ consists of several levels of authority, technical competence, and sources of financial and material resources needed for the task. I have already commented on their assignment with reference to what action those who occupy each level of responsibility may justifiably undertake.

Question:

Does the work programme present a compelling vision for enabling strategic interaction and mutual support across existing initiatives, platforms, forums and programmes, given the stipulation of Res 70/259 that the Decade should be organized with existing institutions and available resources?

Should it embody the modifications suggested here, I think it would be considerably enhanced. However, I am not very sanguine about the proviso, “”existing institutions and available resources,” for many of the existing institutions will have to be altered, and the available resources considerably increased if we are to achieve our objective.

Question:

Do you feel you can contribute to the success of the Nutrition Decade or align yourself with the proposed range of action areas?

I’d be happy to offer my analytic and synthetic skills to improve the shape and consistency of the programme, or in any other way they may prove useful to object of the “Decade”.

Question:

Do you have specific comments on the section on accountability and shared learning?

Material for shared learning could be an invaluable asset provided that it is relevant for an area under conditions existing there. These include the local food culture, unemployment rate, infra-structure, educational opportunities, etc.

As an example of untenable shared learning material, it is difficult to see what scientific justification could be presented in support of global numerical recommendations on nutrients, height, weight, bio-mass etc.

The reason for this is obvious; we need nutrients for various anabolic and catabolic processes, and their requirements vary with reference to age, sex, type of work, during pregnancy and nursing, illnesses, climatic conditions, etc. Hence, they cannot be standardised upon any scientific basis. Moreover, there is reason to believe that what constitutes our dietary needs have a certain racial component, which can be associated with the climatic conditions and the food available under them. Very high protein and fat content of the diet on which peoples of the Arctic Circle subsist and their physical features illustrate this. A similar bias towards protein-rich diet with considerable fat content is observable among nomadic peoples.

With best wishes!

Lal Manavado.

Risk allocation and way forward for successful multistakeholder partnership, engagement and delivery towards food security and nutrition in the face of climate change

In dealing with the challenge of food security and nutrition, countries must act on several fronts in a focused manner simultaneously. One of approach to address the issue is public private partnership (PPP) mode wherein wherein the contractual parties are the public and private partners and the purpose of the document is to govern and establish guidelines for the relationship between all parties. The objective from the public sector point of view is to make sure that the risks are allocated so that the private sector is incentivized to provide the service under the PPP contract but not require the private sector to take risks that they cannot control. The private sector attaches a premium on the risks, which affects the cost of their services. Consequently, the public authority must also consider which risks it will retain because it is able to control these risks more cost effectively. The National Action Plan for food security and nutrition hinges on the development and use of new technologies. The implementation of the Plan would be through appropriate institutional mechanisms suited for effective delivery of each individual Mission's objectives and include public private partnerships and civil society action. The focus will be on promoting understanding of climate change, adaptation and mitigation, energy efficiency and natural resource conservation. Lenders are required in many PPP arrangements, such as concession agreements, to finance the capital investments of a project.

Strategies need to be adopted for active citizen engagement

Capacity building - at both individual and institutional level, greater involvement of private sector through Public Private Partnership and better awareness is important. Top-down anti-corruption practices and national level approaches to improving accountability mechanisms have often failed in fragile and conflict-affected situations. In contrast, identifying and supporting local accountability mechanisms, strengthening partnerships, and supporting collaborative governance and capacity building has been shown to be more effective in these contexts. The accountability triangle involving Citizen, Policymakers and Public Private Partnership provides a way to understand successes and failures along the service delivery chain by analyzing the relationships between policymakers/politicians, service providers and citizens. 

Suggested steps for effective implementation of food security and nutrition strategy

Preliminary risk assessment on food security and nutrition:

An initial risk assessment need to be conducted based on secondary data. The data will be collected from relevant government agencies and authorized organizations. Quick observations of vulnerable communities need to be done to assess the sensitivity and exposure towards food and nutritional insecurity. The risk assessment report need to be compiled and utilized for public awareness and multistakeholder consultations and shared through local and national media. This will help to increase the political will and public support for taking measures to reduce the risk.

Public awareness and community involvement:

This is basically a step for sensitizing public after analysis of risk assessment report with multistakeholders and communities. Their opinion on ways to reduce risk will be further compiled and analysed.

Local institutional mapping:

Existing local institutions that have potential roles in risk reduction will be mapped. This mapping accounts for both government and non-government agencies. The risk assessment report will be shared with identified institutions and their opinion on measures to be taken will be captured.

Policy review:

Review of existing policies on food security and nutrition will be done. The policies and strategies need to be clearly discussed at various levels. A policy brief need to be prepared based on the review and circulated through printing and electronic media.

Multistakeholder consultations:

Consultation meetings with multistakeholders (including political parties, government and non-government agencies, media, academicians) need to be organized. The findings of step of above steps will be shared among all. Consensus on food security and nutrition need to be sought from all the multistakeholders for final implementable strategies. 

English translation below

En mi pais VENEZUELA hay muy poca participacion en sus programas a pesar de que necesitamos mas que otro pais en la region de estos programas ya que tenemos muchos problemas de desnutricion en todas sus categorias como consecuencia de la falta de produccion de alimentos.

Esta situacion a empeorado drasticamente este año pese a los esfuerzos del gobierno de subsidiar algunos alimentos a los mas necesitados sin ningun tipo de resultado por la corrupcion del sistema de distribucion que caracteriza a los empleados que laboran en estos programas.

Enfermedades como la diabetes son mas frecuentes por la falta de azucar en la dieta diaria.

Espero estas sencillas palabras le sean de alguna utilidad, en nombre de mis hermanos, y nos apoyen para mejorar la nutricion en nuestro pais.

SIEMPRE A SUS ORDENES PARA CUALQUIER OTRA INFORMACION QUE NECESITEN

Saludos Ing. Prof. Carlos Granado F

VENEZUELA

Even though my country, VENEZUELA, is the one that most needs these programmes in the region due to the many undernutrition problems caused by food production shortages, the overall involvement of the population is very limited.  

This year this situation has deteriorated dramatically despite the government's efforts to subsidize several food products to those in greatest need. The corrupt distribution system, also affecting the employees working in these programmes, makes the attempt fruitless.

Diseases like diabetes are more frequent due to the lack of sugar in the daily diet.

I hope you find these simple remarks useful, on behalf of my brothers, and that you will help us to improve nutrition in our country.

I REMAIN AT YOUR DISPOSAL TO PROVIDE ANY INFORMATION YOU MAY REQUIRE.

Best regards,

Prof. Eng. Carlos Granado Fernández

VENEZUELA

Dear FSN Forum

Attached please find the PDFdocument with my comments, using note tool. Will be obliged if you can load it. Thanks.

Dr. Ms Mahtab S. Bamji,

INSA Emeritus Scientist, Dangoria Charitable Trust, Hyderabad

1. Does the work programme present a compelling vision for enabling strategic interaction and mutual support across existing initiatives, platforms, forums and programmes, given the stipulation of Res 70/259 that the Decade should be organized with existing institutions and available resources?

To some extent. See comments on the document and under 5.

2. What are your general comments to help strengthen the presented elements of the first draft work programme of the UN Decade of Action on Nutrition?

See comments on the document and under 5.

3. Do you feel you can contribute to the success of the Nutrition Decade or align yourself with the proposed range of action areas?

May be. Being 82 years old retired woman scientist who is now engaged in science and society related programmes with nutrition as focus in the villages of Medak district of the state of Telangana, I have some limitations.

4. How could this draft work programme be improved to promote collective action to achieve the transformational change called for by the 2030 Agenda for Sustainable Development and the ICN2 outcomes? What is missing?

Interdepartmental convergence between food, health, water, environment needs to be emphasised for all countries.

5. Do you have specific comments on the section on accountability and shared learning?

(i)  There should be an executive summary clearly stating the fact that Nutrition security goes beyond food security - though food security is very important. For Nutrition security, there has to be Awareness and Access at Affordable cost to food security, safe drinking water, disease-free environment and health care outreach. This will take care of Absorption. There has to be convergence between these. As it is in India at least, the departments concerned with each of these work in silos.

(ii) The earlier sections prior to Action Areas are rather vague and verbose. See some comments on the manuscript.

(iii) The economic cost of malnutrition, particularly micronutrient deficiencies- the hidden hunger, to a nation needs to be emphasised. Nutrition should be a parameter for judging national development and not just economic parameters like GDP.

(iv) Nutrition should not be subsumed under health. Health often stops at immunisation, oral rehydration etc. Agenda should always be Health, Food  and Nutrition. In India except once, when Dr. Manmohan Singh called malnutrition “a curse”, nutrition never gets mentioned in budgets. This point should be emphasised clearly.

(v) Nutrition should be included as a subject in the professional courses like health and agriculture. As it is the knowledge of physicians and other health workers and agriculture scientists, extension workers is very poor. Latter will help to leverage nutrition into agriculture.

(vi) WTO should bring subsidies relevant to poor in developing countries, in green box. Rich farmers are getting huge subsidies in developed countries.

(vii) Nutrition monitoring and surveillance is mentioned in the table but not so clearly in the text. This is important.

(viii) Table 1 only lists items related to food security. No mention is made of ensuring safe drinking water, disease free environment and access to affordable health care. These are very important.

(ix) Indiscriminate use of antibiotics (including the last resort new  ones) in animal husbandry and fishery is a great threat to development of resistance to  antibiotics in humans and livestock. This point should be brought out clearly.

Following points should be mentioned:

If food variety is too expensive for low income populations, governments can consider to mandate food fortification. An important aspect which is widely neglected is effectiveness. Human does not function on one or 2 nutrients alone. The inclusion of the B-Vitamins for proper messaging in the body and proper cell functioning is essential. Contrary to wide believes fortification with B-Vitamins is not costly. To provide all essential B-Vitamins to 100 million people cost less than 20 million US$ per year.

If industry is providing healthy food options at low prices positive taxation of governments should be considered in order to increase the accessability and availablility of healthy food options.

Governments can support the approval and distribution of healthy food options, specially food options that are targetting the first 1000 days, i.e. adolescant girls.

Small and medium sized enterprises provide 85 % of the global packaged food supply. The SME's must be included in policies that promote sugar, fat and salt reduction and fortification.

Dear Colleagues,

Thank you very much for sending me the report of FSN Global Forum on Maximizing the Impact of the UN Decade of Action on Nutrition, and inviting feedback on the Report.

I have just a couple of suggestions to make:

1. There is no clear mention of achieving the set targets of Sustainable Development Goals (SDGs) by 2030 in this brief, although the 2nd goal of SDGs is “Nutrition” and all countries are working towards that goal. Will this UN Decade (2016-30) help in any way in achieving those country-specific targets on Nutrition? If so, kindly elucidate it further.
2. Coming to LMIC settings including countries of South Asia, there is a genuine problem of food processing/cooking that leads to cultural diversification of food habits, leading towards the loss of nutritive values of consumed food items. This must get prioritized in all interventions and should get focused in nutrition polices, programs and practices.

Looking forward to your earliest response to this regard,

With my best wishes,

>SKMishra

Dr. Surendra Kumar Mishra, Director (Global Programs)

Ansul-India Health & Management Services (AIHMS)

T- 456 E, First Floor, Chirag Delhi, New Delhi –110017 (INDIA)